GMC’s Report on WTR’s Impact on Medical Education and Training

The Royal College of Surgeons of Edinburgh (RCSEd) welcomes the research commissioned by the General Medical Council (published 14 February 2013), regarding the impact of the working time regulations on medical education and training.

Patient safety is a top priority for RCSEd and, as such, the College is extremely concerned about the findings of the research that demonstrate that poorly designed rotas are apparently putting patients at risk.

RCSEd believes that the imposition of a rule on working times by itself will not be sufficient to address the serious issues identified and that the correct approach is to consider the needs of the patients for treatment by fully trained doctors who are working in adequately staffed units.

Doctors in training should be working in well-functioning teams, as a part of those teams, but should not become so essential to the functioning of that team that patient care would suffer if a doctor in training were removed from that unit. RCSEd also agrees that doctors in training should not be working in such isolation such that they feel unsupported by their senior colleagues. This will require imagination and a willingness to consider different ways of working to conserve patient safety.

College Council Member, Elaine Griffiths, said:

"We believe that patients should be at the centre of care and that patients are entitled to a service delivered by trained health care professionals. Junior doctors in training should have exposure to all training opportunities including on call rotas but not be expected to deliver the service unsupervised. The move to shift working has had a detrimental effect on the work life balance of trainees and the increased number of hand overs is detrimental to continuity of care and patient safety.

"It is essential that the government provides resources to ensure a fully staffed trained multidisciplinary workforce to provide the service element of NHS care and designated trainers to ensure high quality training to doctors in training."

RCSEd looks forward to working with the GMC and other partners to highlight good practice in designing rotas and to review how working patterns can be managed and monitored. Flexibility is the key to ensure valuable continuity of care and patient safety.

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